A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images
PurposeTo investigate the feasibility and dosimetric index features of dose painting guided by perfusion heterogeneity for brain metastasis (BMs) patients.MethodsA total of 50 patients with single BMs were selected for this study. CT and MR simulation images were obtained, including contrast-enhance...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.828312/full |
| _version_ | 1828177413517869056 |
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| author | Chuanke Hou Hanjing Yin Guanzhong Gong Lizhen Wang Ya Su Jie Lu Yong Yin |
| author_facet | Chuanke Hou Hanjing Yin Guanzhong Gong Lizhen Wang Ya Su Jie Lu Yong Yin |
| author_sort | Chuanke Hou |
| collection | DOAJ |
| description | PurposeTo investigate the feasibility and dosimetric index features of dose painting guided by perfusion heterogeneity for brain metastasis (BMs) patients.MethodsA total of 50 patients with single BMs were selected for this study. CT and MR simulation images were obtained, including contrast-enhanced T1-weighted images (T1WI+C) and cerebral blood flow (CBF) maps from 3D-arterial spin labeling (ASL). The gross tumor volume (GTV) was determined by fusion of CT and T1WI+C images. Hypoperfused subvolumes (GTVH) with less than 25% of the maximum CBF value were defined as the dose escalation region. The planning target volume (PTV) and PTVH were calculated from GTV and GTVH respectively. The PTVN was obtained by subtracting PTVH from PTV, and conventional dose was given. Three kinds of radiotherapy plans were designed based on the CBF values. Plan 1 was defined as the conventional plan with an arbitrary prescription dose of 60 Gy for PTV. For dose painting, Plan 2 and Plan 3 escalated the prescription dose for PTVH to 72 Gy based on Plan 1, but Plan 3 removed the maximum dose constraint. Dosimetric indices were compared among the three plans.ResultsThe mean GTV volume was 34.5 (8.4-118.0) cm3, and mean GTVH volume was 17.0 (4.5-58.3) cm3, accounting for 49.3% of GTV. Both conventional plan and dose painting plans achieved 98% target coverage. The conformity index of PTVH were 0.44 (Plan1), 0.64 and 0.72 (Plan 2 and Plan 3, P<0.05). Compared to Plan 1, the D2%, D98% and Dmean values of the PTVH escalated by 20.50%, 19.32%, and 19.60% in Plan 2 and by 24.88%, 17.22% and 19.22% in Plan 3 respectively (P<0.05). In the three plans, the index of achievement value for PTVH was between 1.01 and 1.03 (P<0.05). The dose increment rates of Plan 2 and Plan 3 for each organs at risk (OARs) was controlled at 2.19% - 5.61% compared with Plan 1. The doses received by OARs did not significantly differ among the three plans (P >0.05).ConclusionsBMs are associated with significant heterogeneity, and effective escalation of the dose delivered to target subvolumes can be achieved with dose painting guided by 3D-ASL without extra doses to OARs. |
| first_indexed | 2024-04-12T04:58:31Z |
| format | Article |
| id | doaj.art-b59c3382c2f74081b567d266869053d0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T04:58:31Z |
| publishDate | 2022-12-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-b59c3382c2f74081b567d266869053d02022-12-22T03:47:03ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-12-011210.3389/fonc.2022.828312828312A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion imagesChuanke Hou0Hanjing Yin1Guanzhong Gong2Lizhen Wang3Ya Su4Jie Lu5Yong Yin6Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaDepartment of Radiation Physics, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, ChinaPurposeTo investigate the feasibility and dosimetric index features of dose painting guided by perfusion heterogeneity for brain metastasis (BMs) patients.MethodsA total of 50 patients with single BMs were selected for this study. CT and MR simulation images were obtained, including contrast-enhanced T1-weighted images (T1WI+C) and cerebral blood flow (CBF) maps from 3D-arterial spin labeling (ASL). The gross tumor volume (GTV) was determined by fusion of CT and T1WI+C images. Hypoperfused subvolumes (GTVH) with less than 25% of the maximum CBF value were defined as the dose escalation region. The planning target volume (PTV) and PTVH were calculated from GTV and GTVH respectively. The PTVN was obtained by subtracting PTVH from PTV, and conventional dose was given. Three kinds of radiotherapy plans were designed based on the CBF values. Plan 1 was defined as the conventional plan with an arbitrary prescription dose of 60 Gy for PTV. For dose painting, Plan 2 and Plan 3 escalated the prescription dose for PTVH to 72 Gy based on Plan 1, but Plan 3 removed the maximum dose constraint. Dosimetric indices were compared among the three plans.ResultsThe mean GTV volume was 34.5 (8.4-118.0) cm3, and mean GTVH volume was 17.0 (4.5-58.3) cm3, accounting for 49.3% of GTV. Both conventional plan and dose painting plans achieved 98% target coverage. The conformity index of PTVH were 0.44 (Plan1), 0.64 and 0.72 (Plan 2 and Plan 3, P<0.05). Compared to Plan 1, the D2%, D98% and Dmean values of the PTVH escalated by 20.50%, 19.32%, and 19.60% in Plan 2 and by 24.88%, 17.22% and 19.22% in Plan 3 respectively (P<0.05). In the three plans, the index of achievement value for PTVH was between 1.01 and 1.03 (P<0.05). The dose increment rates of Plan 2 and Plan 3 for each organs at risk (OARs) was controlled at 2.19% - 5.61% compared with Plan 1. The doses received by OARs did not significantly differ among the three plans (P >0.05).ConclusionsBMs are associated with significant heterogeneity, and effective escalation of the dose delivered to target subvolumes can be achieved with dose painting guided by 3D-ASL without extra doses to OARs.https://www.frontiersin.org/articles/10.3389/fonc.2022.828312/fullbrain metastasesradiotherapydose painting3D-arterial spin labelingsubvolume |
| spellingShingle | Chuanke Hou Hanjing Yin Guanzhong Gong Lizhen Wang Ya Su Jie Lu Yong Yin A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images Frontiers in Oncology brain metastases radiotherapy dose painting 3D-arterial spin labeling subvolume |
| title | A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| title_full | A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| title_fullStr | A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| title_full_unstemmed | A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| title_short | A novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| title_sort | novel approach for dose painting radiotherapy of brain metastases guided by mr perfusion images |
| topic | brain metastases radiotherapy dose painting 3D-arterial spin labeling subvolume |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.828312/full |
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